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2023 Application - Form

This document is an application form for admission to the University of Lusaka. It requests personal information such as name, contact details, nationality, academic background, employment history, and program of study. It provides instructions on completing and submitting the form along with required supporting documents such as academic transcripts, identification documents, and references. It notes the application fees, intake periods, and admission categories. The applicant must declare the accuracy of the information and sign and date the form.

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Wei Lee
Copyright
© © All Rights Reserved
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138 views3 pages

2023 Application - Form

This document is an application form for admission to the University of Lusaka. It requests personal information such as name, contact details, nationality, academic background, employment history, and program of study. It provides instructions on completing and submitting the form along with required supporting documents such as academic transcripts, identification documents, and references. It notes the application fees, intake periods, and admission categories. The applicant must declare the accuracy of the information and sign and date the form.

Uploaded by

Wei Lee
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ADMISSIONS OFFICE:

P.O. Box 36711, Lusaka, Zambia.


Phone: +260 211 258 409/505 | Cell: +260 976 075 850
Customer Service/WhatsApp: +260 972 832 671
Email: [email protected] Website: www.unilus.ac.zm

APPLICATION FOR ADMISSION


OFFICIAL USE ONLY RECEIPT No.______________
INSTRUCTIONS
• Please read through the form carefully before filling it in.
• Application form cost - K200 for Undergraduate and K250 for Postgraduate
• Provide information where appropriate. PASSPORT
• Enclose an academic reference. SIZE
• Attach all supporting documents (i.e Grade 12 results, NRC and or qualifications).
• Applications must be sent to the above address. PHOTO
• Please write in block letters and mark with an “X“ where appropriate e.g. [x]
NOTE: GRADE 12 RESULTS, NRC AND CERTIFICATES SHOULD ALL BE CERTIFIED COPIES

U N D E R G R A D U AT E P O S T G R A D U AT E

PROGRAMME INFORMATION
Programme Applied for:.....................................................................................................................................................

Second Choice:..................................................................................................................................................................

INTAKE: January [ ] June [ ] YEAR : 2023 [ ] 2024 [ ] 2025 [ ]


MODE OF STUDY: Full-Time [ ] Part-time [ ] Distance [ ]
APPLICANT CATERGORY: School Leaver [ ] Non-School Leaver [ ]

PERSONAL INFORMATION
*Please fill in your names as they appear on your NRC/Passport

Surname:............................................................................................................................................
Other Names......................................................................................................................................
SEX: Male [ ] Female [ ] Date of Birth:_____/______/_____ Marital Status: Married [ ] Single [ ]
Nationality:........................................................................................................................................................................

National Registration Card No.(NRC):............................................................................................................................

If Non- Zambian, Passport No:........................................................................................................................................

CONTACT DETAILS
*Ensure that the email listed is reliable. All correspondence will be made to the listed email

Phone Number:................................................................ Alternative Number:..............................................................

Email Address:..................................................................................................................................................................

Postal Address:................................................................................................................................................................

Residential Address:........................................................................................................................................................

NEXT OF KIN

Full Names:........................................................................................................................................................................

Phone Number:............................................................. Alternative Number:.................................................................

Email Address:..................................................................................................................................................................

Postal Address:................................................................................................................................................................

Residential Address:........................................................................................................................................................
ACADEMIC BACKGROUND
(Attach certified copies of Transcripts and certificates)

Previous Educational Institution Attended From To Qualification Obtained


(Secondary & University/ College)
1

ARE YOU EMPLOYED? YES [ ] NO [ ] Details of employment (Attach CV)


Employer:................................................................................................................................
Period:.....................................................................................................................................
Position held:...........................................................................................................................
Nature of Responsibility:..........................................................................................................
PERSONAL BRIEF

In what ways do you feel the programme of study will affect your personal and career
development?
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................

Do you have any permanent injury, illness or disability which may affect your ability to study?
Yes [ ] No [ ] . If yes, please describe the nature of your injury, illness or disability.
................................................................................................................................................
................................................................................................................................................

APPLICATION FORM CHECKLIST FOR APPLICANTS [x] EXEMPTION


REQUEST
1. High School Certificate/Statement of results [ ]
2. National Registration Card/Passport/Drivers License [ ] YES [ ] NO [ ]
3. Attach two (2) Passport Sized Photo [ ]
4. Application form completely filled out accurately [ ]
If yes, kindly refer
5. Payment for application form attached (Deposit Slip) [ ]
to the exemptions
Postgraduate applicants must also attach the following: request form on
6. Degree Certificate/Professional Qualification (e.g Full ACCA/CIMA/ZICA)/Statement of results page 3
7. Two Reference Letters (One Academic & One Professional)
8. Curriculum Vitae

Note: Applicants should ensure that this form is complete and all the required attachments at submitted.
Incomplete application forms will not be processed.

DECLARATION
I certify that the information given in this application and supporting documents is accurate and complete. I
understand that the University Of Lusaka reserves the right to reverse any offer of admission made on the basis
of inaccurate information.

Signature_____________________________________ Date________________________
ADMISSIONS OFFICE:
UNIVERSITY P.O. Box 36711, Lusaka, Zambia.
Phone: +260 211 258 409/505 | Cell: +260 976 075 850
of LUSAKA Customer Service/WhatsApp: +260976200094
Email: [email protected] Website: www.unilus.ac.zm

EXEMPTIONS REQUEST FORM

OFFCIAL USE ONLY RECEIPT No.______________


INSTRUCTIONS
• Please read through the form carefully before filling it in.
• Provide information where appropriate.
• Please write in block letters and mark with an “X“ where appropriate e.g. [x]
Note: All certificates submitted will be re-verified with the Examination Council of Zambia

STUDENT INFORMATION
*Please fill in your names as they appear on your NRC/Passport

Surname:.............................................................................................................................................

Programme:.......................................................................................................................................................................

Student Number:...............................................................................................................................................................

TRANSCRIPT/STATEMENT OF RESULTS ATTACHED: YES [ ] NO [ ]

CONTACT DETAILS

Phone Number:................................................................ Alternative Number:..............................................................

Email Address:..................................................................................................................................................................

Postal Address:................................................................................................................................................................

OFFICIAL USE ONLY


COURSES EXEMPTED

RECEIVED BY:________________________________ PROCESSED BY:________________________________

APPROVED:__________________________________ COMMENT:_____________________________________

DATE:_______________________________________ DATE:_________________________________________

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